KevinMD Features Op-Ed from Past Project HealthDesign PI

Libby Dowdall, Communications Coordinator, Project HealthDesign National Program Office

Visit KevinMD.com today to read “Using a mobile app to help chronic pain,” an op-ed by Roger Luckmann, M.D., M.P.H. Dr. Luckmann, who is a family physician, served as principal investigator of a past Project HealthDesign team from the University of Massachusetts Medical School. His team designed an electronic pain and activity diary to help patients document their daily pain experiences, medication regimens and physical activities. This system inspired Dr. Luckmann’s work on a similar mobile application that is set to launch in the Mac App Store soon. Read the article to hear Dr. Luckmann’s perspective on effectively managing pain by learning more about patients’ daily lives and activities.

Developer Challenge Roundup

Libby Dowdall, Communications Coordinator, Project HealthDesign National Program Office

From new PHR platforms to creative mobile health applications, the opportunities for improving health and health care seem to multiply daily. We hope to see more developers and designers become passionate innovators in the health and health care space. Participating in developer challenges such as these upcoming opportunities might help you catch the vision!

Robert Wood Johnson Foundation Challenge

Aligning Forces Challenge

• The challenge: Develop an application that builds on the publicly available Aligning Forces for Quality (AF4Q) health care quality measures and helps patients access better care.
• Requirements and desired functionality: The application should incorporate AF4Q health care quality measures, allow patients easy access to inpatient and outpatient health resources, and guide them through the decision-making process.
• End of submission period: December 31
• Learn more or register for the challenge.

ONC i2 Challenges

One in a Million Hearts Challenge

• The challenge: Develop an application that empowers individuals to improve their heart health.
• Requirements and desired functionality: The application should educate individuals about the Million Hearts initiative, allow individuals to input information about their current health state, use the health data they provide to generate targeted recommendations about how to improve their heart health, and be capable of transferring the individual’s information to an EHR using Direct specifications.
• End of submission period: December 31
• Learn more or register for the challenge.

popHealth Tool Development Challenge

• The challenge: Create an application that leverages the popHealth open source framework and provides greater insight into patient populations (e.g., help clinicians improve patient safety, help providers engage patients and families, etc.).
• End of submission period: January 20
• Learn more or register for the challenge.

Reporting Device Adverse Events Challenge

• The challenge: Develop an application that facilitates the reporting of adverse events related to patient use of medical devices in hospitals, clinics and home environments.
• Requirements and desired functionality: The application should allow patients to record adverse events easily, integrate with EHR and PHR platforms, capture patient demographic information, capture information about the medical device, be platform-agnostic, and employ NwHIN standards.
• End of submission period: February 3
• Learn more or register for the challenge.

popHealth Tool Development Challenge

• The challenge: Work with a public health expert to co-create an application makes it easy for users to use the Healthy People 2020 Leading Health Indicators (LHIs) in meaningful ways.
• End of submission period: March 9
• Learn more or register for the challenge.

Pairing Text Messaging with the BreathEasy Application

Robert Furberg, MBA, Ph.D., BreathEasy Text Messaging Pilot Lead, RTI International

In the past 10 years, there’s been a huge increase in the use of cell phones (particularly smartphones); social media, including Twitter, Facebook and blogs; networking tools; and information sharing systems, including mobile geolocation applications such as Foursquare. These tools may offer new opportunities for enhancing techniques and processes for collecting health data, including participant recruitment; tracing; maintaining contact with participants in longitudinal studies; cognitive interviewing; and passive data collection.

Text messaging is one of the most popular communication methods in the world. The pervasiveness, low cost and convenience of mobile phones make Short Message Service (SMS) texting an ideal tool for disseminating health information to—as well as gathering health information from—consumers. It’s also a direct and immediate route to reach people; I tend to think of it as the most intimate form of high-tech communication.

Despite these advantages, rigorous evaluations of new technologies in health services research applications have been rare. The few SMS interventions that have been well-studied suggest that text messaging systems can effectively increase medication and appointment adherence and sustain health promotion behaviors such as smoking cessation, diabetes, asthma management and depression.

I’ve been so enamored of texting and its potential over the past couple of years that I decided to build an SMS platform for sending and receiving messages for health behavior change interventions. After reflecting on these trends and considering how we can make the BreathEasy smartphone experience more engaging, we hit on the idea of integrating SMS notifications with the application.

So that’s where we are now: devising and testing methods to tie our SQL back end from the BreathEasy application side to the SMS platform in order to generate three kinds of messages. The first type of tailored reminder prompts participants to complete diary entries and/or provide peak flow readings; the second involves health alerts related to air quality, excessive use of rescue inhalers and peak flow readings; the third type of messages are health promotion messages that address general wellness and smoking cessation.

For BreathEasy, rather than focusing on text messaging as a mode of intervention or primary collection of observations of daily living (ODLs), we decided to try using SMS as an adjunctive technology. Our SMS-adjunct (SMS-a), is intended to support the collection of ODLs; SMS-a provides participants interactive, dynamically tailored compliance reminders via a smartphone application. Beyond serving as a technical and process proof of concept, we intend to evaluate the effect of SMS-a on increasing participant satisfaction, retention and data quality.

We’re eager to get started with ODL collection and even more excited to observe how things go with this integration. We’ll be sure to update you about our experience when we go live.

Learn more about BreathEasy.
Read more posts from the BreathEasy team.

Using Cell Phones to Improve the Health of Babies and Children Around the World

Karen Cheng, FitBaby Co-Principal Investigator, University of California, Irvine

One of the things I love about our project and the other Project Health Design projects is the creative use of cell phones to collect data and share health information. Cell phones have so much potential to expand access to health care for people who, for any number of reasons (e.g., lack of health insurance, distance to a health facility, unsure when it is appropriate to go see a doctor), might have limited access.

I recently learned of an organization operating in the West African country of Mali that uses some of the same methods we use in FitBaby. Like our project, Pesinet is committed to the early detection and prevention of illnesses among babies and young children. The similarities between our projects show the power of mobile technology to improve health for children around the world. The differences highlight the stark contrasts between our problems and needs here in the U.S. and the problems and needs in West Africa.

FitBaby focuses on infants who are highly at risk for long-term chronic illness because they were born pre-term. Pesinet works with infants and young children (up to age five, 20 percent of whom do not live to see their fifth birthdays) in Mali — almost all are high-risk because of the poverty and lack of health care in the country.

Both projects use cell phones to record health information about the children and then transmit the data via the cellular network to a central database, where health care professionals can access the data and review it for concerns. In the FitBaby project, we offer smartphones to parents so that they can record weight, diaper use, fussiness and other ODLs in the convenience of their homes. Parents can use the data to help determine if they should contact a health care provider about their baby’s health. A nurse case manager may also contact parents if she or he is concerned about the baby’s health indicators. Pesinet sends trained health care workers to families’ homes weekly to assess weight, diarrhea, fever, vomiting and cough (learn more). The health care workers use a cell phone to record data, transmit the data to a central health facility and receive feedback about whether the family should take the child in for further medical evaluation.

I find it thrilling that cell phones can be used in similar ways all around the world to serve the health needs of babies and young children. Best wishes to the folks at Pesinet! May your work be successful in improving the health of thousands of babies in Mali!

Learn more about the FitBaby project.
Read more posts from the FitBaby team.

RWJF’s Steve Downs on the Future of Mobile Health

In his recent blog post, “Data, Apps and the Rules that Bind Them,” Steve Downs, assistant vice president of the Robert Wood Johnson Foundation’s Health Group, comments on the popularity of mobile health and the importance of personal health record (PHR) data. In the post, Downs notes several policy questions related to mobile health privacy and security that must be addressed if the mHealth surge is to continue.

“Until policymakers step in and provide guidance, the chilling effect on innovation will continue, furthering our reliance on an antiquated model of care that does little to empower patients to be active participants in their own health decisions.”

He notes three PHR-related themes that are particularly important as policymakers look toward the future of mobile health: separating the apps from the data, expansion of the definition of health information, and the increasingly social nature of health care.

Read the full post on the Pioneering Ideas blog.